HomeMy WebLinkAboutBuilding Permit Application Oct 0515O3:28p Breathe Healt7�27814G34 p
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Oct 05 15 03:23p Breathe HealthierAir Inc 7727814634 p.2
-SUPPLEMENTAL CONSTRUCTION. LIEN LAW INFORMATIOM
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Add rens: Address:
City: State: City: -_ I State:
Zip: Phone- Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City. City:
Zip., -Phone- Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit Will authorize theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or angcovenant5 that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If yo),4 intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
gnature M_&ner/Less gent Signature of Con traZtbr/l.teLsnse Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF lik OLT t IQ COUNTY OF MF%Q_Tf J�.t
The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me
this I t day of 15eel, 20 by this 11 day of 5W 20106 by
(Na of persona I) Name of person acknowledging}
1qfA
Si nature of NotaryOublic- ate of Florida J (SigAature of Notary ublic ate of Florida
Personally Knqw- Per I.Ay"nAWR Q_R Rgiod4wa.414 ientification
Type of Ident.. K JANSSEJ Ty+*ff�& KJANSSEN
I., td .....ificllillhamm
;Jy CUWtSSION#FF235643 my COMMISSION A FF235U3
Commission . ...... EXLtRES May MSO19 Colwo. EXPIRES May Z6. 019 (Sea])
►14 30641s3-
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS